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Rituximab Therapy for Acute Humoral Rejection After Kidney Transplantation

2007; Wolters Kluwer; Volume: 83; Issue: 9 Linguagem: Inglês

10.1097/01.tp.0000261113.30757.d1

1534-6080

Stanislas Faguer, Nassim Kamar, Céline Guilbeaud-Frugier, Marylise Fort, Anne Modesto, Arnaud Mari, David Ribes, Olivier Cointault, Laurence Lavayssière, Joëlle Guitard, D. Durand, Lionel Rostaing,

Renal Diseases and Glomerulopathies

A pilot study was performed on eight consecutive renal-transplant (RT) patients presenting with acute humoral rejection (AHR) to assess the efficacy of monoclonal anti-B cell antibodies, such as rituximab (375 mg/m2 weekly) for 3 to 5 consecutive weeks, in addition to plasma exchange (PE), steroids, mycophenolate mofetil, and tacrolimus. AHR was associated with increased serum creatinine, the appearance of donor-specific alloantibodies (DSA), and the presence of C4d in a transplant biopsy. After a follow-up of 10 months (range 7–23), patient and graft survivals were 100% and 75%, respectively. Renal function improved in six cases in which serum creatinine decreased from 297±140 to 156±53 μmol/L (P=0.015); graft loss occurred in two cases; and four patients had infectious complications. At last follow-up, DSA had disappeared or decreased in four cases. Rituximab therapy, in addition to PE, might be of benefit for RT patients presenting with AHR.